Della Magnusson doesn’t have to look far for a reminder of why the work she does matters.
Hundreds of smiling faces wallpaper her office at the Westside Community Clinic — mothers, babies and growing families she’s supported over her years as a nurse practitioner in Saskatoon’s core neighbourhoods.
Magnusson does all of the prenatal and women’s health care at the clinic. She started the photo wall when it dawned on her that many of her patients didn’t own cameras.
Once that got going, people started dropping off photos for her to include. Some are of toddlers she saw as infants; others are memorial notices for members of the community she knew.
Tucked away on the side of a cabinet are pictures of her two daughters.
“So many people will look at it and go, ‘Oh my gosh, the girls are getting so big!’ and I didn’t even think anybody would really notice or comment on it,” Magnusson said. “It was always really nice that people saw me as a human and not a professional, that I had kids too and I was a mother.”
Including herself in her work and building trust with her patients is crucial to the work Magnusson does at the clinic and Sanctum 1.5, a first-of-its-kind, 10-bed prenatal care home for high-risk and HIV positive pregnant women.
Magnusson is passionate about improving women’s care and eliminating barriers to care that exist for them.
Many of the pregnant women she supports are HIV positive. If treated with an antiretroviral while pregnant, the likelihood of having an HIV-positive baby is less than one per cent.
Many are also living with addiction or homelessness or other factors that make them wary of accessing health care.
“I think one of Della’s biggest strengths is her ability to engage and build trusting relationships with women who typically do not engage in health care because of historical trauma,” said Sanctum Care Group executive director Katelyn Roberts.
“We see that every day at Sanctum when she provides care here — the moms trust her. And the way she advocates for this population is second to none.”
The photo wall is a testament to the success of her approach. In her nearly 13 years working at the clinic since 2007, she and her team have been the primary care providers for 80 to 100 HIV positive mothers and their babies, including five sets of twins.
None of the babies has been HIV positive.
“What I like about this is that some of the babies on this wall are from moms who are HIV positive and some are from moms who are healthy, and they’ve all been born healthy,” Magnusson said. “So when they’re all together it really shows there’s no difference.”
Magnusson received her diploma in nursing in 1985. In the years that followed, she worked everywhere from Baffin Island to as far south as the Virgin Islands, doing contract work in an advanced care role.
She ultimately returned to her home province of Saskatchewan to become a nurse practitioner, working largely in remote, northern communities before joining the Westside Clinic. That northern work gave her a solid foundation for the work she does now.
While the scope of practice for nurse practitioners includes connecting people with community services and providing education, Magnusson champions expanding the role NPs can take in a community as conduits for support. With that comes building trust into the health care system.
“The whole clinic believes in setting people up for success as opposed to failure,” Magnusson said. “Building that trust, being honest, working with people where they’re at, trying to get them to where their goals are and utilizing everybody as a team has really worked, and so I just kind of fit into this place.”
Aside from her full-time role at the clinic, Magnusson makes the rounds two days a week at Sanctum 1.5 as the home’s primary care provider. She also works part-time on the Health Bus.
In many cases, the women she sees at Sanctum have appointments at Westside and eventually access services via the bus. For Magnusson, being able to be there every step of the way is proof of how integrating health care into the community is crucial.
Kathy Malbeauf, an RN and program director with Sanctum Care Group, said Magnusson often goes above and beyond her role, despite her workload.
“She has helped provide care for our palliative patients across the street (at Sanctum, an HIV-positive hospice and transitional care home). She has sat with some of our babies in withdrawal and monitored them, Malbeuf said.
“That is not something she had to do. She wanted to do it. After having worked all day in the clinic, she has that much commitment left at the end of the day to come in for an all-nighter.”
Malbeuf and Roberts said Magnusson was instrumental in Sanctum 1.5’s creation.
At a time when the province was still apprehending infants into care, she was part of discussions about what could be done to foster collaboration between the Ministry of Social Services and front line workers in order to better care for mothers.
“It was always kind of my dream when we started doing that, that we had this need for a place or home that mothers could be working in an upstream component where they could go prenatally, especially if they’re struggling with addictions and homeless and needing help,” she said.
Sanctum 1.5, which opened last fall, was the eventual result.
The fact that Magnusson provides care to the vulnerable women living in the community makes her the go-to for anything prenatal, Roberts said. It also made her a natural fit coming into her role at Sanctum 1.5.
“Everyone loves Della in this community, trusts her; she creates a safe space,” Roberts said. “If you can impact vulnerable people who typically don’t engage in these services and have them speak as highly as they do about Della, I think that says a lot about who she is.”
As Magnusson walks the alley behind 20th Street West connecting Sanctum 1.5 and the clinic, she points out all of the different services clustered nearby.
It’s a similar walk to the one she took when she was getting situated in her role — meeting with everyone from medical specialists to residents in order to put a face to her name and build trust.
Crossing behind St. Mary’s Parish, Magnusson passes a clinic with ultrasound imaging services and specialists, the Saskatoon Tribal Council’s Health Centre — which houses SHARP (Saskatoon HIV/AIDS Reduction in harm Program) — and finally, the building that will house the province’s first safe consumption site operated by AIDS Saskatoon.
AIDS Saskatoon executive director Jason Mercredi anticipates as many as 250 clients accessing the safe consumption site and as many as 300 accessing the attached drop-in centre.
If this summer is anything to go on, Magnusson agrees it will be busy. The rising use of crystal meth in Saskatchewan has introduced new challenges to her work.
“The crystal meth use and the drug use just exploded, and of course along with that our HIV exploded as well,” she said.
The rate of new diagnoses of HIV in Saskatchewan is about two and a half times higher than the national average. Intravenous drug use is the largest contributing factor to transmission in the province.
“Drug use in the city, it’s huge; it’s beyond what we ever thought it would be,” Magnusson said. “Ten to 12 years ago we were dealing with cocaine only, not crystal meth. And now crystal meth is taking over everything. It’s not just the core neighbourhoods.”
Magnusson’s job isn’t just educating her patients. She also wants to break down the public stigma around living with addiction and HIV.
She strives to pass on that message, both through the students she supervises at the Student Wellness Initiative Towards Community Health (SWITCH) clinic and her own daughters, who volunteer at SWITCH and The Bridge on 20th Fellowship Centre.
“I tell my students that the people I work with are somebody’s mother, father, brother, sister. It could be my family, and I think it’s really important when you put it that way, that these people are human and things happen to people,” she said.
“My work building a better understanding as far as (my daughters) for the next generation to carry through has been like a really proud moment for me.”
The trust Magnusson has built in the community as a result of her compassionate approach to care is apparent as she makes the rounds at Sanctum 1.5.
The women living there easily hand her their babies, some of them newborns, simply to rock or do a quick checkup. She quickly elicits a giggle from babies sleeping in cribs throughout the home’s main floor as she pauses to give them a smile.
Seeing those babies grow up, and the gains their mothers can make with the right support, are some of the greatest rewards of her work, she says.
“At any given moment in health care, you have the ability to make a difference. If you give the time and the care that’s needed towards that and build the trust, I think it goes beyond whatever you can do. Because people can do it, they just need the support.”
Photo by Liam Richards, The Saskatoon StarPhoenix